What You Need to Know:
December 1st marked the 31st annual World AIDS Day. This day is dedicated to bringing attention to the HIV epidemic, decreasing associated stigma, increasing response toward ending the HIV epidemic, and to celebrate those who have lost their battle to HIV/AIDS. This year’s theme was “Ending the HIV/AIDS Epidemic: Community by Community”.
More than 1.1 million people in the United States are currently infected with HIV. Nearly 15% of those with HIV are undiagnosed. In 2017, nearly 40,000 people were newly diagnosed with HIV infection. Men who have sex with men, those who are gay and bisexual comprise the majority of this group; however, heterosexuals are also affected. Almost 25% of those with HIV are heterosexual and include 7% men, 16% women, and 6% intravenous drug users. African Americans and Hispanic/Latino populations are disproportionately affected.
Laboratory tests are used to confirm diagnosis of an HIV infection. The ELISA HIV Antibody test, which is corroborated by Western blot, has a sensitivity greater than 99.5% and a specificity of approximately 100%. HIV antibodies develop in about 95% of persons within the first six weeks after contracting the infection. A CD4 lymphocyte count may also be used and will demonstrate a decrease in absolute CD4 counts as the risk for opportunistic infection increases in persons with HIV. The HIV viral load test is the best test to employ for detecting acute HIV infection prior to seroconversion.
Patients with HIV often have systemic symptoms which cause distress or interfere with daily life, including diarrhea, weight loss and body wasting, and excessive sweating. They are at increased risk of developing opportunistic infections, which can be life-threatening. Often, HIV + patients experience non-Hodgkin lymphoma and other aggressive cancers. They may also experience neurological impairment and disease, including neuropathy, dementia, and aseptic meningitis.
Prevention strategies to avoid HIV include behavior modification, education, and support. Practicing safe sex with latex condoms, not sharing needles, if using intravenous drugs, and adding pre-exposure prophylaxis (PrEP) with antiretroviral drugs are recommendations which can be shared with those at risk. Male circumcision in adults has been shown to decrease HIV acquisition by 50-65%, and is being implemented in some developing countries with HIV/ AIDS outbreaks as an attempt to weaken this epidemic.
Read More About HIV and AIDS:
Harrison’s Principles of Internal Medicine, 20e: Chapter 197. Human Immunodeficiency Virus Disease: AIDS and Related Disorders
Symptom to Diagnosis: An Evidence-Based Guide, 4e: Chapter 5. AIDS/HIV Infection
The Color Atlas and Synopsis of Family Medicine, 3e: Chapter 226. AIDS and Kaposi Sarcoma